Cortical microinfarcts and demyelination significantly affect cognition in brain aging

Details

Serval ID
serval:BIB_598569717599
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cortical microinfarcts and demyelination significantly affect cognition in brain aging
Journal
Stroke
Author(s)
Kövari Enikö, Gold Gabriel, Herrmann François R., Canuto Alessandra, Hof Patrick R., Michel Jean-Pierre, Bouras Constantin, Giannakopoulos Panteleimon
ISSN
0039-2499
Publication state
Published
Issued date
2004
Peer-reviewed
Oui
Volume
35
Number
2
Pages
410-414
Language
english
Notes
SAPHIRID:64345
Abstract
BACKGROUND AND PURPOSE: Microvascular lesions are common in brain aging, but their clinical impact is debated. Methodological problems such as the masking effect of concomitant pathologies may explain discrepancies among previous studies. To evaluate the cognitive consequences of such lesions, we prospectively investigated elderly individuals with various degrees of cognitive impairment but without significant neurofibrillary tangle pathology or macrovascular lesions. METHODS: This was a clinicopathological study of 45 elderly individuals. Cognitive status was assessed prospectively with the Clinical Dementia Rating (CDR) scale; neuropathological evaluation included Abeta-protein deposition staging and bilateral semiquantitative assessment of cortical microinfarcts, focal cortical and white matter glioses, and diffuse white matter and periventricular demyelination. RESULTS: In a univariate logistic regression model, cortical microinfarcts explained 36.1% of the variability in CDR; periventricular demyelination, 10.6%; and diffuse white matter demyelination, 4.6%. After controlling for age and Abeta-protein deposition, cortical microinfarcts were the best predictor of cognitive status (19.9% of CDR variability), whereas periventricular and diffuse white matter demyelination accounted for 9.7% and 5.4% of CDR variability, respectively. Altogether, these 3 types of microvascular lesions explained 27.9% of the clinical variability. Focal cortical and white matter glioses were not related to clinical outcome. CONCLUSIONS: Our data imply that cortical microinfarcts and both periventricular and deep white matter demyelination contribute significantly to the progression of cognitive deficits in brain aging. In contrast, the neuropathological evaluation of focal cortical and white matter gliosis has no clinical validity.
Pubmed
Web of science
Open Access
Yes
Create date
10/03/2008 11:04
Last modification date
20/08/2019 14:13
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